YCLOAK

Preparations are under way for a mass Ebola vaccination campaign in the Democratic Republic of Congo as the Ministry of Health and international aid agencies hold a second day of inoculations in northwestern Equateur Province. The latest World Health Organization estimates report 51 cases of Ebola, including 27 deaths.

The World Health Organization said 33 people, most of them front-line health care workers, were vaccinated against Ebola on Monday in Mbandaka, a city of more than one million people. It said a few high-risk people from the community also were vaccinated during the first day of the campaign.

More than 7,500 doses of the Ebola vaccine have been shipped to the Democratic Republic of Congo. WHO spokesman Tarik Jasarevic told VOA he expects the campaign to accelerate and ultimately reach thousands of people.

He said a lot of work has to be done before this complex operation can hit its stride. For example, he said transporting the vaccines and storing them in freezers in affected areas is a major challenge.

“You need to have vaccination teams to be trained so they know exactly what they need to do, how to get a consent, how to define eligibility of a contact and contacts of contacts,” he added. “So, all of that has to be done in a very, very short period of time under very difficult conditions.”

Jasarevic said a team from Doctors Without Borders will begin vaccinations later in the week in Bikoro, the remote rural town in northwestern Equateur Province, where the deadly Ebola virus was discovered two weeks ago.

The Ebola vaccine is not licensed, but a major trial in 2015 in Guinea showed it gave a high rate of protection against the disease. A so-called ring vaccination strategy is being applied. It relies on tracing all the contacts and extended contacts of a recently confirmed case as soon as possible. More than 600 contacts have been identified.
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The Ebola outbreak that has killed more than two dozen people in northeastern Democratic Republic of Congo could be as devastating as the one that hit West Africa several years ago, if left unchecked.

But first responders say things are different this time. That’s in large part thanks to a vaccine they couldn’t use in late 2013, when Ebola cases were first reported in Guinea.

The pharmaceutical giant Merck has shipped about 8,600 doses of its experimental vaccine, V920, to the site of the outbreak in Equateur province. The drug has gone through Phase 3 trials, but has not yet received regulatory licensure in any country.

It will be administered in Congo by the World Health Organization, a Merck spokesperson told VOA.

‘Ring vaccination’

Having an effective vaccine isn’t enough, the head of policy and health diplomacy at the Africa Centres for Disease Control and Prevention, Dr. Benjamin Djoudalbaye, told VOA by phone from Geneva.

V920 isn’t designed for mass vaccination. People who have come in contact with a patient must be identified and given the drug.

“But the difficult part,” Djoudalbaye said, “is to properly list down all the contacts and press them in such a way that they (understand they) can benefit from the vaccine and it will stop the spread of the disease.”

The WHO will follow the “ring vaccination” approach, wherein anyone who has come into contact or may come into contact with an infected person is vaccinated to contain the threat.  This could include family members, funeral workers, health workers and others in close contact with a patient.

So far, V920 has prevented everyone vaccinated from contracting the virus. In a 2015 trial, none of the 5,837 people who received the vaccine became sick.

A Merck spokesperson said in an email that the company plans to file for licensure in 2019, but it has made the vaccine available due to the Congo outbreak.

The WHO has requested an additional 8,000 doses, and Merck said it is working to fulfill that request.

Spread to neighboring countries?

On May 18, the East African Community regional bloc warned its members that the virus could potentially spread from the DRC due to direct flights between the countries and extensive trade relations.

“Five out of six EAC partner states share borders with the DRC, and all of them maintain close trade relations with high border traffic,” the statement alerted.

The WHO has not declared a state of emergency, and travel to and from the DRC has not been restricted.

But Djoudalbaye, who just returned from the DRC, said there are no sure things in disease control. It’s just a matter of lowering the risk as much as possible. “The risk ‘zero’ doesn’t exist,” he said, “That is what we need to have all keep in mind.” But strong action from the government can limit the disease from spreading, he added.

Djoudalbaye says health officials, NGOs and governments learned many lessons from the West Africa Ebola outbreak in 2014 and 2015, including the importance of a health-response infrastructure to support rapid intervention.

Key to that effort has been the Africa Centres for Disease Control and Prevention, which opened in early 2017.

Existing systems and earmarked resources have enabled a speedy response in the DRC, Djoudalbaye said. “After the declaration of the Ebola outbreak in DR Congo on the eighth (of May), by the tenth, we were on the ground.”

V920 isn’t new. A team of scientists led by University of Manitoba researchers Steven M. Jones and Heinz Feldmann invented the vaccine in 2003 at the Public Health Agency of Canada, in Winnipeg. Initial tests showed promise. Just one shot of the vaccine prevented macaque monkeys exposed to high levels of Ebola from getting sick.

But development of the drug faltered. Lengthy, expensive clinical trials didn’t happen, until the worst Ebola outbreak in recorded history unfolded more than a decade later, in 2014 and 2015. By then, the vaccine had been licensed to Merck, and its effectiveness in humans had been established.

More than 11,000 people died in the West Africa outbreak four years ago, and nearly 30,000 cases were recorded, mainly in Guinea, Liberia and Sierra Leone. Trials of V920 in the outbreak region helped reduce the caseload and ultimately stop the epidemic.

Ongoing funding

Keeping the virus contained and the death toll as low as possible will require ongoing funding, experts say.

“If funding is cut, it will really be pulling the rug out from under health security. And countries that look to other countries that can help will be left alone again as these things will continue,” said Cyrus Shahpar, the director of the Prevent Epidemics team at the Resolve to Save Lives initiative, a New York-based organization working to manage disease threats.

“The spread hasn’t gone away. Obviously we have this new Ebola outbreak, but I think that the memory of what happened in West Africa has kind of waned a bit, and so funding is also starting to wane. And I think it’s absolutely the wrong thing to do,” Shahpar said.
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Supervised by young engineers, workers at the start-up company Chakr Innovation in New Delhi cut and weld sheets of metal to make devices that will capture black plumes of smoke from diesel generators and convert it into ink. 

In a cabin, young engineers pore over drawings and hunch over computers as they explore more applications of the technology that they hope will aid progress in cleaning up the Indian capital’s toxic air – among the world’s dirtiest. 

While the millions of cars that ply Delhi’s streets are usually blamed for the city’s deadly air pollution, another big culprit is the massive diesel generators used by industries and buildings to light up homes and offices during outages when power from the grid switches off – a frequent occurrence in summer. Installed in backyards and basements, they stay away from the public eye. 

“Although vehicular emissions are the show stoppers, they are the ones which get the media attention, the silent polluters are the diesel generators,” says Arpit Dhupar, one of the three engineers who co-founded the start up. 

The idea that this polluting smoke needs attention struck Dhupar three years ago as he sipped a glass of sugarcane juice at a roadside vendor and saw a wall blackened with the fumes of a diesel generator he was using. 

It jolted him into joining with two others who co-founded the start-up to find a solution. Dhupar had experienced first hand the deadly impact of this pollution as he developed respiratory problems growing up in Delhi.

A new business

As the city’s dirty air becomes a serious health hazard for many citizens, it has turned into both a calling and a business opportunity for entrepreneurs looking at ways to improve air quality.

According to estimates, vehicles contribute 22 percent of the deadly PM 2.5 emissions in Delhi, while the share of diesel generators is about 15 percent. These emissions settle deep into the lungs, causing a host of respiratory problems. 

After over two years of research and development, Chakr has begun selling devices to tap the diesel exhaust. They have been installed in 50 places, include public sector and private companies.

The technology involves cooling the exhaust in a “heat exchanger” where the tiny soot particles come together. These are then funneled into another chamber that captures 70 to 90 percent of the particulate matter. The carbon is isolated and converted into ink. 

Among their first clients was one of the city’s top law firms, Jyoti Sagar Associates, which is housed in a building in Delhi’s business hub Gurgaon. 

Making a contribution to minimizing the carbon footprint is a subject that is close to Sagar’s heart – his 32-year-old daughter has long suffered from the harmful effects of Delhi’s toxic air.

“This appealed to us straightaway, the technology is very impactful but is beautifully simple,” says Sagar. Since it could be retrofitted, it did not disrupt the day-to-day activities at the buzzing office. “Let’s be responsible. Let’s at least not leave behind a larger footprint of carbon. And if we can afford to control it, why not, it’s good for all,” he says. 

At Chakr Innovation, cups, diaries and paper bags printed with the ink made from the exhaust serve as constant reminders of the amount of carbon emissions that would have escaped into the atmosphere. 

There has been a lot of focus on improving Delhi’s air by reducing vehicular pollution and making more stringent norms for manufacturers, but the same has not happened for diesel generators. Although there are efforts to penalize businesses that dirty the atmosphere, this often prompts them to find ways to get around the norms. 

Tushar Mathur who joined the start up after working for ten years in the corporate sector feels converting smoke into ink is a viable solution. “Here is a technology which is completely sustainable, a win-win between businesses and environment,” says Mathur. 
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The government of Rwandan President Paul Kagame — accused by some of imposing authoritarian rule on the country — received almost unanimous praise for its strides in health care. Kagame had a chance to tout his health care policy as an example to other African nations at the opening of the World Health Assembly in Geneva Monday.

According to Rwandan officials, the country’s universal health care system has brought coverage to more than 90 percent of its population.

 

Kagame, an advocate for the adoption of universal health coverage in Africa,  leads a country that has a successful, widely-admired system. As chairman of the African Union, he has promoted universal coverage as the continent’s top strategic objective.

The effort is receiving full support from the World Health Organization, which aims to achieve coverage for one billion more people by 2023 as part of a five-year strategic plan.

Touting his own efforts as an example, Kagame says achieving universal health coverage is feasible for countries at every income.These systems, he says, avoid catastrophic out-of-pocket health expenditures, which are an increasing source of impoverishment in Africa.

He says community-based, primary health systems all around Africa have shown good results.

“In Rwanda,” he said, “a combination of community-based health insurance, community health workers, and good external partnerships led to the steepest reductions in child and maternal mortality ever recorded.”

Kagame says more than 90 percent of Rwandans are enrolled in health insurance today. He says two-thirds of the costs are borne by the beneficiaries, with the government subsidizing the remaining one-third.

He says it acts as a boon for entrepreneurship, helps families invest in their children’s education, and allows for the economic empowerment of women.

Kagame’s account of his success is largely uncontested by the WHO, western aid agencies, and the media. Virtually all of the publicity surrounding Rwanda’s health care achievements in the West has been overwhelmingly positive.

But to international human rights organizations and his political opponents at home, Kagame is using the success of his health care policy to shadow a more sinister aspect of his rule. Amnesty International says this is characterized by widespread human rights abuses including unlawful killings and unresolved disappearances.

Rwanda’s clampdown on freedom of expression is so severe, the group Reporters Without Borders calls Kagame a “predator of press freedom.”
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A southern white rhino at the San Diego Zoo in California has become pregnant as a result of artificial insemination with sperm from a male southern white rhino. The development increases hopes that a nearly extinct close relative, the northern white rhino, can be saved.

News that the female southern white rhino named Victoria is pregnant is seen as a breakthrough, and a step toward saving the northern white rhino species. The pregnancy was confirmed last week. If Victoria is able to carry the calf to term, it will be born in about a year.

The San Diego Zoo Institute for Conservation Research issued a statement that said confirmation of this pregnancy through artificial insemination represented a “historic event” for the organization and was a critical step in the effort to save the northern white rhino.

The world’s last male northern white rhino, Sudan, died after age-related complications in March at Kenya’s Ol Pejeta Conservancy, his home for 10 years after being transferred from a zoo in the Czech Republic. Sudan was 45 years old and had been in ailing health.

Sudan’s death was seen as a tragedy, as it marked the possible end of a species.

Researchers optimistic

Reproductive options for producing a northern white rhino include artificial insemination, in vitro fertilization and embryo transfer, with the southern white rhinos possibly serving as surrogates for northern white rhino embryos. 

The statement from the institute said researchers were optimistic that a northern white rhino calf could be born from these procedures within 10 to 15 years. 

Kenya is home to the last remaining northern white rhinos, Sudan’s daughter Najin, and granddaughter, Fatu.

The second-to-last male northern white rhino, Suni, died in 2014. Suni had also been brought back to Africa from the Czech Republic.

Sudan and Suni were too old to mate by the time they left Europe.

A team at Ol Pejeta is also working on a different project that seeks to save the northern white rhino from extinction.

Serve as surrogate

The plan is to harvest eggs from the two remaining northern white females. The animals cannot be artificially inseminated because they are infertile. Scientists intend to use an Ol Pejeta southern white rhino as a surrogate for northern white rhino eggs.

“Ol Pejeta is working on invitro fertilization,” said Richard Vigne, CEO of Ol Pejeta Conservancy.

“There are two northern white rhino females left. Both are infertile — they cannot get pregnant. So, what we want to do is remove eggs from their ovaries. We want to take the eggs, and we want to fertilize them in a test tube with northern white rhino sperm to create an embryo which can then be implanted into southern white rhino females acting as surrogate mothers, to eventually produce a pure bred northern white rhino calf exactly as it happens in humans.”

Paul Gathitu,  a Kenya Wildlife Service spokesman, said any news toward wildlife conservation is good news.

“Any indication that technology, science, will be able to propagate this creates hope, and particularly for animals that are on the extinction path,” Gathitu said. “For humanity, it’s a good sign. It means that there is a possibility we could turn to science and technology and see contributions toward conservation.”

Human big part of problem

Vigne said people have a responsibility to help save endangered species because humans are the top reason for endangerment.

“I think there is a bit of hope for the northern white rhino, but I think the important point that people need to understand is that it is not only the northern white rhino that is threatened by extinction,” Vigne said.

“There are thousands of other species across the planet that are currently facing extinction as a result of human activity. While we may be able to save the northern white rhino by spending a lot of money on it, the truth of the matter is, all of the other species that are threatened by extinction will go extinct unless the way that humans interact with our environment changes.”

Poaching has escalated in recent years and is being driven by the demand for Ivory. Rhino populations worldwide, in the meantime, continue to dwindle due to poaching. 
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In homes and pubs, on leaflets and lampposts, debate is raging in Ireland over whether to lift the country’s decades-old ban on abortion. Pro-repeal banners declare: “Her choice: vote yes.” Anti-abortion placards warn against a “license to kill.”

 

Online, the argument is just as charged — and more shadowy, as unregulated ads of uncertain origin battle to sway voters before Friday’s referendum, which could give Irish women the right to end their pregnancies for the first time.

 

The emotive campaign took a twist this month when Facebook and Google moved to restrict or remove ads relating to the abortion vote. It is the latest response to global concern about social media’s role in influencing political campaigns, from the U.S. presidential race to Brexit.

 

“We shouldn’t be naive in thinking Ireland would be immune from all these worldwide trends,” said lawmaker James Lawless, technology spokesman for the opposition Fianna Fail party.

 

“Because of the complete lack of any regulation on social media campaigning in Ireland, somebody at the moment can throw any amount of money, from anywhere in the world, with any message — and there’s nothing anybody can do about it.”

 

The role of online ads in elections is under scrutiny following revelations that Russian groups bought ads on platforms such as Google and Facebook to try to influence the 2016 U.S. presidential race. Many of the ads were designed to sow confusion, anger and discord among Americans through messages on hot-button topics.

 

Few subjects are more emotive than abortion, especially in largely Roman Catholic Ireland. Despite the country’s growing diversity and liberalism — voters legalized gay marriage in a 2015 referendum — the vote is expected to be close. The campaign is being watched, and sometimes influenced, by anti-abortion groups in the U.S. and elsewhere.

 

Voters are being asked whether they want to keep or repeal the eighth amendment to Ireland’s constitution, added in 1983, which commits authorities to defend equally the right to life of a mother and an unborn child. Abortion is legal only in rare cases when the woman’s life is in danger, and several thousand Irish women travel each year to terminate pregnancies in neighboring Britain.

 

Prime Minister Leo Varadkar’s center-right government backs lifting the ban and allowing abortion on request up to 12 weeks of pregnancy.

 

Ireland is no stranger to referendums — this is its fifth in five years — and the country’s electoral laws regulate traditional forms of campaigning. Radio and television ads are banned completely, and foreign political donations are outlawed. But the 20-year-old electoral rules don’t cover social-media advertising, and there is no limit on campaign spending.

 

“It’s a complete Wild, Wild west,” said Craig Dwyer of the Transparent Referendum Initiative, a volunteer group set up to collect information on the ads being used to target Irish Facebook users. “When we started collecting this information there was absolutely zero regulation.”

 

The group has compiled and analyzed almost 900 Facebook ads connected to the referendum. Many were placed by registered lobby groups, and most came from inside Ireland. But several dozen were either untraceable or from overseas, including some that have been linked to U.S.-based anti-abortion organizations.

 

Several pages, with names like “Just the Facts About the 8th Amendment” and “Undecided on the 8th,” claimed to give neutral information but had a clear anti-abortion agenda.

 

Such pages can be used to identify undecided voters, who can then be targeted with tailored ads — a practice that has been under scrutiny since revelations that political consultancy Cambridge Analytica harvested Facebook users’ data to micro-target select groups during the U.S. presidential race.

 

Concern about the impact of online ads led Facebook to announce May 8 that it would no longer accept referendum-relayed advertisements from outside Ireland in order to “ensure a free, fair and transparent vote.”

 

A day later, Google went even further, halting all referendum advertising as part of efforts to protect “election integrity.” The company said it was aware of “concerns” around the issue but declined to say what prompted the decision.

 

Research by the Transparent Referendum Initiative and University College Dublin found “some indications of large-scale spending on unregulated Google and YouTube ads” before Google’s ban.

 

Google’s decision infuriated anti-abortion campaign Save the Eighth, which was about to launch a series of YouTube ads when Google, which owns the video-sharing site, pulled the plug.

 

Spokesman John McGuirk accused the Mountain View, California-based search giant of “direct foreign interference in a referendum campaign.”

 

“You have a multinational corporation essentially saying that this country’s democracy is compromised, and they have provided no evidence for that whatsoever,” he said.

 

McGuirk dismisses the role of overseas ads in the referendum, saying most were “small, amateurish ads basically made by John and Mary in New Jersey telling Irish people to pray the rosary for a `no’ vote. They weren’t helping us in the first place.”

 

McGuirk sees allegations of shady social-media advertising as an attempt to undermine the “no” campaign because it was winning the online war. As with the Trump and pro-Brexit campaigns, Save the Eighth paints itself as an underdog, battling what it sees as pro-repeal bias among mainstream media and politicians.

 

The pro-repeal campaign insists it was equally disadvantaged by the Google ban.

 

“We had a Google strategy that was in place, we were spending money,” said Peter Tanham, head of digital for Together For Yes. “We had to spend a day readjusting our plans.”

 

Both sides agree that tech firms should not be the ones making important decisions about Ireland’s democracy. Lawless has introduced a bill to parliament that would require all online advertisers to disclose the publishers and sponsors behind ads.

 

“We should not be looking to boardrooms in Silicon Valley to see how our elections should be governed,” he said.

 

The lawmaker’s bill may become law later this year, too late to influence Friday’s vote. Polls suggest the “yes” side has a lead, but it may be narrowing — and almost one in five voters say they are undecided.

 

While both sides say online ads are an important part of their strategy, many feel the argument will be won the old-fashioned way: through personal contact, one voter at a time.

 

“It was a blow when Google said they weren’t going to play more ads,” said Siobhan McAteer, a 25-year-old “no” campaigner distributing leaflets on a Dublin street. “It was a bit upsetting, but the momentum is in the streets. It’s our campaigners talking to people on the streets.”

 

 

 

 
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 In an energetic presentation, World Health Organization director-general, Tedros Adhanom Ghebreyesus, has kicked off the agency’s annual conference in Geneva by vowing to use his position to keep the world safe and to serve the vulnerable by promoting health for all.

The overflow audience at the Assembly enthusiastically marked the World Health Organization’s 70th Birthday. WHO Chief Tedros Adhanom Ghebreyesus agreed there was much to celebrate. But noted there was little joy in the Democratic Republic of Congo where health workers were risking their lives to stop the Ebola outbreak in that country.

“It is concerning that we now have cases of Ebola in an urban center, but we are much better placed to deal with this outbreak than we were in 2014. I am pleased to say that vaccination is starting as we speak today,” he said.

Tedros said this was only the latest of 50 emergencies in 47 countries and territories to which WHO has responded in the past year. He noted the best way to prevent future disease outbreaks and emergencies was to strengthen health systems everywhere.

“That is why we established a High-Level Commission on Noncommunicable Diseases, to stop the premature and preventable deaths of millions of people,” he said. “It is why we established an initiative on climate change and health in small island developing states … It is why we are working on an aggressive new initiative to jumpstart progress against malaria, an entirely treatable disease that still kills half a million people every single year.”

WHO has rolled out an ambitious new five-year strategic plan, which aims to make a big impact on health. Tedros said the goal is to achieve the highest attainable standard of health for all peoples in the world, poor and rich alike.
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China launched a relay satellite early on Monday designed to establish a communication link between earth and a planned lunar probe that will explore the dark side of the moon, the official Xinhua news agency said.

Citing the China National Space Administration, Xinhua said the satellite was launched at 5:28 a.m. (2128 GMT Sunday) on a Long March-4C rocket from the Xichang launch center in the southwest of the country.

“The launch is a key step for China to realize its goal of being the first country to send a probe to soft-land on and rove the far side of the moon,” Xinhua quoted Zhang Lihua, manager of the relay satellite project, as saying.

It said the satellite, known as Queqiao, or Magpie Bridge, will settle in an orbit about 455,000 km (282,555 miles) from Earth and will be the world’s first communication satellite operating there.

China aims to catch up with Russia and the United States to become a major space power by 2030. It is planning to launch construction of its own manned space station next year.

However, while China has insisted its ambitions are purely peaceful, the U.S. Defense Department has accused it of pursuing activities aimed at preventing other nations from using space-based assets during a crisis. 
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The Democratic Republic of Congo plans to launch an Ebola vaccination program Monday to stop another widespread outbreak of the deadly disease.

More than 4,000 doses of vaccine have been shipped to the large port city of Mbandaka, where three cases of the virus have been confirmed since last week and two are suspected. More vaccine is on the way.

Twenty-six Ebola-related deaths have been reported in northwestern DRC since April along with a number of suspected cases.

“Previous outbreaks have demonstrated the importance of a rapid and well-resourced response in order to save lives, but also prevent an exponential increase in the economic cost of a response,” World Health Organization spokesman Tarik Jasarevic said Sunday.

The WHO and Congolese health officials are striving to stop outbreak from moving down river from Mbandaka to Kinshasa, where 10 million people live.

President Joseph Kabila and his Cabinet have increased Ebola emergency response funds to more than $4 million.

The latest Ebola outbreak is the ninth in the DRC since the 1970s.

A 2013 outbreak in West Africa lasted more than two years and killed more than 11,300 people. Most of the victims lived in Guinea, Liberia, and Sierra Leone with other cases scattered as far away as the United States.

Ebola causes internal bleeding, vomiting, and diarrhea and is spread through direct contact with a victim’s bodily fluids. There is no specific treatment.

An outbreak in a densely populated urban area could be catastrophic, experts say.

 
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Congo’s health ministry announced one new death from Ebola Sunday, bringing to 26 the number of deaths from the deadly outbreak in Equateur province in the country’s northwest.

Four new cases of the Ebola virus have been confirmed in the Democratic Republic of the Congo, according to country’s health ministry most recent statement.

A total of 46 cases of the hemorrhagic fever have been reported in the current outbreak: 21 confirmed cases of Ebola, 21 probable and four suspected.

President Joseph Kabila and his Cabinet decided Saturday to increase funds for Ebola emergency response which amounts to more than $4 million.

Health Minister Oly Ilunga said late Friday the new cases of the often lethal virus were confirmed in Mbandaka city, a city of 1.2 million people where another case was confirmed days earlier.

The United Nations World Health Organization declined to declare the outbreak an international health emergency but said the risk of the virus spreading within the country was “very high.” The WHO said there was also a high risk of it spreading to nine neighboring countries but maintained there should be no travel or trade restrictions in the region.

A new, experimental vaccine is expected to be administered beginning early next week. The vaccine was effective in a West African outbreak a few years ago. Four-thousand doses are already in Congo and more shipments are enroute. Congolese health officials are challenged with keeping the vaccine cold in a large country where the infrastructure is in poor condition.

This is the ninth Ebola outbreak in Congo in more than 40 years, but the earlier ones were limited to rural areas. There were two outbreaks in the capital of Kinshasa, which has a population of 10 million people, but they were quickly stopped.

There is no specific treatment for the virus, which is lethal and highly contagious. The latest virus is of the same strain that spread in three West African countries for two years beginning in 2013, creating global panic. By the time its spread was halted, the virus had killed more than 11,300 people, making it the most deadly Ebola outbreak ever.

 
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Three new cases of the often lethal Ebola virus have been confirmed in a city of more than 1 million people, Congo’s health minister announced, as the spread of the hemorrhagic fever in an urban area raised alarm.

The statement late Friday said the confirmed cases are in Mbandaka city, where a single case was confirmed earlier in the week.

There are now 17 confirmed Ebola cases in this outbreak, including one death, plus 21 probable cases and five suspected ones.

The World Health Organization on Friday decided not to declare the outbreak a global health emergency, but it called the risk of spread within Congo “very high” and warned nine neighboring countries that the risk to them was high. WHO said there should be no international travel or trade restrictions.

The outbreak is a test of a new experimental Ebola vaccine that proved effective in the West Africa outbreak a few years ago. Vaccinations are expected to start early in the week, with more than 4,000 doses already in Congo and more on the way.

A major challenge will be keeping the vaccines cold in the vast, impoverished country where infrastructure is poor.

While Congo has contained several Ebola outbreaks in the past, all of them were based in remote rural areas. The virus has twice made it to Congo’s capital of 10 million people, Kinshasa, in the past but was rapidly stopped.

Health officials are trying to track down more than 500 people who have been in contact with those feared infected, a task that became more urgent with the spread to Mbandaka, which lies on the Congo River, a busy traffic corridor, and is an hour’s flight from the capital.

The outbreak was declared more than a week ago in Congo’s remote northwest. Its spread has some Congolese worried.

“Even if it’s not happening here yet I have to reduce contact with people. May God protect us in any case,” Grace Ekofo, a 23-year-old student in Kinshasa, told The Associated Press.

A teacher in Mbandaka, 53-year-old Jean Mopono, said they were trying to implement preventative measures by teaching students not to greet each other by shaking hands or kissing.

“We pray that this epidemic does not take place here,” Mopono said.

The WHO, which was accused of bungling its response to the West Africa outbreak, the biggest Ebola outbreak in history with more than 11,000 deaths, appears to be moving swiftly to contain this latest epidemic, experts said.

There is “strong reason to believe this situation can be brought under control,” said Dr. Robert Steffen, who chaired the WHO expert meeting on Friday. But without a vigorous response, “the situation is likely to deteriorate significantly.”

This is the ninth Ebola outbreak in Congo since 1976, when the disease was first identified. The virus is initially transmitted to people from wild animals, including bats and monkeys. It is spread via contact with bodily fluids of those infected.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain.
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